We considered all the evidence we gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;' Is the service caring?
' Is the service responsive?
' Is the service safe?
' Is the service effective?
' Is the service well led?
Below is a summary of what we found '
Is the service caring?
Staff we spoke with were able to describe the type and frequency of care that people received and also talk about their individual backgrounds, likes and dislikes. People who used the service told us, 'This place is lovely. They staff are lovely; its service with a smile'; 'It's lovely here. I like it very much. I would recommend it to anyone'; 'I get all the help I need'; 'All the care workers are nice; you get to have a good laugh with them' and 'The staff are lovely; they help with what I need help with.' Relatives we spoke with told us, 'It's not clinical, it's more homely'; 'The staff are very patient and good with the residents' and 'I'm really happy with things.'
We saw care staff interacted well with people, were warm, supportive and spent individual time with them during meal times. We observed staff delivering care at other times and noted they were patient and compassionate and supported people to be as independent as possible.
Is the service responsive?
We saw from people's care records that the home worked closely with other services to deliver care to people who used the service. For example, we saw that one person had particularly complex health needs which required the involvement from a range of professionals, including diabetic services, wheelchair services and the tissue viability nurses (TVN). The manager told us that they were working closely with the TVN and that the person's pressure areas were improving slowly.
We saw that call bells were answered in a timely manner and that care was delivered when staff responded to people's calls for assistance.
People we spoke with told us that a range of activities took place and that trips out of the home were arranged. People, relatives and staff talked enthusiastically about a recent fair held at the home, which had been on a wartime theme and involved staff dressing up. People told us, 'We do all sorts of games and entertainment; lots of different things' and ' We do keep fit; I enjoy that, get entertainers and I had a lovely day at the fair on Saturday.' One of the staff told us, 'One of the things about (activities co-ordinator) is that she does one to one activities with people, those that can't join in the other stuff.'
Is the service safe?
We walked around the home on arrival for our inspection and found that the premises were clean, tidy and generally well maintained.
Staff we spoke with had a good understanding of infection control issues. Staff were able to talk in details about the need to use personal protective equipment (PPE), such as aprons and gloves, and the need to change PPE between tasks. They were also able to discuss the need for good hand hygiene with the home. We observed staff wore PPE when providing personal care to people and during meal times.
On the day of our inspection a fire alarm test was carried out to ensure the systems worked effectively. We noted that alarms could be heard throughout the building and automatic doors closed when the system was tested.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager told us that there were no current applications in relation to DoLS. Staff within the home had received training on DoLS and the Mental Capacity Act 2005.
Is the service effective?
We saw that people's general care needs were addressed and that they had appointments with dentists, chiropodists and opticians. We noted that were people's care needs changed then action was taken and care plans updated to acknowledge this change.
We spoke to one of the tissue viability nurses who had visited the home. She told us that she had no concerns about the home and staff worked well with her and always followed the care plans or advice that she gave. She told us, 'The nursing staff are very caring and interested in the patients.'
Is the service well led?
The home had a range of quality assurance system in place to monitor the quality and consistency of care. The manager carried out a range of checks and audits. We saw copies of documents regarding checks on nutrition, equipment fire safety systems, water systems and the general environment within the home.
People that we spoke with told us that they had been given information about making complaints but not raised any formal complaints. People told us, 'I've never had to make a complaint, but if I did have any worries I'd go to the manager first; she would definitely take notice of anything.' Relatives we spoke with told us, 'I've only ever raised one issue and it was dealt with straight away' and 'If I have any issues I just see (the manager) or one of the girls and it is sorted straight away.'
Staff we spoke with told us that there were regular staff meetings and we saw copies of minutes from these meetings. We saw that a range of subjects were discussed including the importance of staff wearing name badges. We saw that all staff at the home were wearing badges to make it easier for people or relatives to identify them.